Department of Children and Family Services (DCFS) Day Care Service Eligibility Application Completed Form Examples and Samples

Caseworker Memo: October 14, 2026. RE: Foster Placement of the Miller children and daycare needs for the primary applicant, Sarah Miller. Sarah, who lives at 452 Maple Street, Springfield, IL 62704, is requesting initial day care service eligibility due to her full-time employment as a nurse. Her Family ID is 99823-X. Sarah works consistent shifts, Monday through Friday, 7:00 AM - 4:00 PM. Her husband, Thomas Miller, is also employed at TechSystems Corp and shares the caregiving responsibility, though the primary need is driven by Sarah’s schedule. We are finalizing placement for two children: James (DOB 05/12/2021) and Lily (DOB 09/20/2023). Both children will attend 'Bright Start Learning Center' located at 1200 Industrial Way, Springfield, IL 62703. The center is a licensed facility (License #12345, Exp 01/01/2028). Sarah has already verified that the facility is safe, has working smoke and carbon monoxide detectors, and maintains current physical and TB records for staff. She is aware that DCFS payments are taxable and that she must provide the facility with emergency contacts. All documents, including her W-9 and authorization for background checks, have been submitted to the regional office. I have reviewed the application with her, and she understands the appeal process and the necessity of notifying the Department if her work schedule changes. This case is currently under the North-Central Region office, handled by caseworker Jane Doe (Worker ID: 44556).